[Chemotherapy for medullary cancer of the thyroid. Phase II trials with adriamycin and cis-platinum administered as monochemotherapy]

Medullary thyroid carcinoma (MTC) is a rare tumor, and patients with distant metastases have a poor prognosis. Chemotherapy efficacity is not well established and we have conducted a phase II trial of monochemotherapy with Adriamycin (ADR) and Cis-platinum (CDDP) in 18 patients. Fourteen MTC have been treated by ADR, the dose was 60 mg/m2 every 4 weeks. The mean number of administration has been 5.3. The results have been: 1 complete response (6 months), 1 partial response (36 months), 1 minor response, 4 stabilisations and 6 failures. The overall responses rate has been 15 per cent and the toxicity has been low. Fourteen MTC have been treated by CDDP. Ten patients had been treated before with ADR. The dose of CDDP was 90 mg/m2 in two hours perfusion with hyperhydration administered every 4 weeks. The mean number of treatment has been 5. The results have been: 1 complete response (9 months), 2 partial responses (16 and 48 months), 4 stabilisations and 7 failures. The overall responses rate has been 21 per cent. In conclusion, ADR and CDDP have some, but limited, efficiency in treatment of metastatic MTC. The effect of their association must be evaluated.

[Chemotherapy of germ-cell tumors of poor prognosis and role of intensification with hematological support]

Poor-risk germ-cell tumors are defined by the presence of high serum tumor marker and large tumor burden. The standard treatment of this group of patients is four cycles of a combination of bleomycin, etoposide and cisplatin followed by the surgical exeresis of residual disease. Neither cisplatin dose-intensification nor alternating chemotherapy protocols, high-dose induction protocols and high-dose consolidation regimens have demonstrated better results than the standard chemotherapy regimen. The salvage treatment of germ-cell tumors is a combination of vinblastine, ifosfamide and cisplatin followed by the surgical exeresis of residual disease. The role of high-dose consolidation chemotherapy is studied in an international randomized trial. However high-dose chemotherapy is inactive in refractory disease patients. Innovative trials are developed in this group of patients.

[Chemoprevention of cancer of the prostate]

Prostate cancer is an important problem of health care. Experimental models of chemoprevention, particularly involving retinoids derivates have been described. Clinical trials are going on in the United States to demonstrate the role of finasteride in the prevention of prostate cancer.

[Management of cancers of the testis. Results in 61 cases and current trends (author's transl)]

Progress in the management of dysembryoma and choriocarcinoma of the testis has been achieved by more effective chemotherapy (particularly since CDDP was introduced) and by precise timing of surgery, occasional radiotherapy and chemotherapy. In their study, the authors have divided the 61 cancers treated into three stages, depending on whether the lesions were limited to the testis (7 patients with choriocarcinoma and 4 with dysembryoma), had invaded the lymphnodes (16 patients with choriocarcinoma and 9 with dysembryoma) or were disseminated (15 patients with choriocarcinoma and 10 with dysembryoma). The prospects of cure are about 90% for stage 1,75% for stage II and 50% for stage III.

[Therapeutic strategy in metastatic renal cancer]

Prognostic factors have been described in metastatic renal cell cancer: performance status, weight loss, elevated erythrocyte sedimentation rate, presence of liver metastases. The treatment for a patient with good prognosis consists of: surgical exeresis of solitary metastasis, immunotherapy by either interferon or interleukin 2. Treatment in case of a rom prognosis is a combination of supportive care, orthopedic surgery for pathologic fracture or medullar compression, antalgic radiotherapy, embolization, nephrectomy for hematuria, and analgesic treatments.